Bone Marrow Engraftment Analysis

Several other molecular tests have a role in the laboratory evaluation of CML patients. In the setting of ASCT, chimerism analysis by variable number tandem repeats (VNTR), short tandem repeats (STR), or single nucleotide polymorphisms (SNP) is used for assessment of bone marrow engraftment of donor cells and to detect the presence of residual recipient cells, so-called mixed chimerism (see chapter 46). After successful transplantation with full donor engraftment, the presence of mixed chimerism is associated with a higher risk of disease relapse.33 Increasing levels of the BCR-ABL1 transcripts may be associated with mixed chimerism such that quantitative real-time RT-PCR and chimerism analysis together may provide information to guide early therapeutic intervention.34